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2016 ; 18
(2
): 262-8
Nephropedia Template TP
gab.com Text
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A systematic review of clinical practice guidelines and best practice statements
for the diagnosis and management of varicocele in children and adolescents
#MMPMID26680032
Roque M
; Esteves SC
Asian J Androl
2016[Mar]; 18
(2
): 262-8
PMID26680032
show ga
A systematic review was conducted to identify and qualitatively analyze the
methods as well as recommendations of Clinical Practice Guidelines (CPG) and Best
Practice Statements (BPS) concerning varicocele in the pediatric and adolescent
population. An electronic search was performed with the MEDLINE, EMBASE, Science
Direct, and Scielo databases, as well as guidelines' Web sites until September
2015. Four guidelines were included in the qualitative synthesis. In general, the
recommendations provided by the CPG/BPS were consistent despite the existence of
some gaps across the studies. The guidelines issued by the American Urological
Association (AUA) and American Society for Reproductive Medicine (ASRM) did not
provide evidence-based levels for the recommendations given. Most of the
recommendations given by the European Association of Urology (EAU) and European
Society of Pediatric Urology (ESPU) were derived from nonrandomized clinical
trials, retrospective studies, and expert opinion. Among all CPG/BPS, only one
was specifically designed for the pediatric population. The studied guidelines
did not undertake independent cost-effectiveness and risk-benefit analysis. The
main objectives of these guidelines were to translate the best evidence into
practice and provide a framework of standardized care while maintaining clinical
autonomy and physician judgment. However, the limitations identified in the
CPG/BPS for the diagnosis and management of varicocele in children and
adolescents indicate ample opportunities for research and future incorporation of
higher quality standards in patient care.